Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. California (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Lake County Tribal Health Consortium Inc. (NPI 1881697381)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lake County Tribal Health Consortium Inc.
Address	925 Bevins Ct
City	Lakeport
State	CA
ZIP	95453
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 27, 2005

Payer Source	Total Paid
Medicaid	$140.6M
Medicare	$0

LAKE COUNTY TRIBAL HEALTH CONSORTIUM INC. reports $140.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a Medicaid-focused, single-payer operation in the available claims data. Its NPI was enumerated on 2005-05-27 (~21 years ago), indicating a long-established presence in the community.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 93.1% of this provider's total Medicaid revenue, with T1015 generating $71.2M (50.6%), 00003 generating $46M (32.8%), and G0467 generating $13.7M (9.8%). This concentration indicates that a very small set of encounter/visit codes drive nearly all reported Medicaid receipts.

The code mix is consistent with a Federally Qualified Health Center model: T1015 (Clinic visit/encounter, all-inclusive) alone represents $71.2M and 50.6% of Medicaid revenue, and G0467 (FQHC visit, established patient) accounts for $13.7M and 9.8% of revenue. These high-value, bundled visit codes suggest the organization is primarily reimbursed through per-encounter FQHC bundles rather than fee-for-service payments for individual procedures.

One coded item, 00003 (no description available), contributes $46M (32.8% of Medicaid revenue) and ranks #51 of 688 providers in-state (93th percentile; typical, unremarkable volume for this code). The lack of a description combined with very large revenue share implies this is a core, high-value billing identifier for the provider—likely a state- or payer-specific encounter or bundled payment mechanism that functions alongside standard FQHC visit codes.

LAKE COUNTY stands out on G0467 activity: it ranks #7 of 1029 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), indicating exceptional relative volume of established-patient FQHC visits compared with peers. By contrast, its T1015 volume ranks #303 of 1550 (81th percentile; typical, unremarkable volume for this code), so the provider is especially prominent on the Medicare-style FQHC visit metric represented by G0467 versus other visit codes.

Several ancillary and therapeutic services appear in the mix but contribute modest revenue relative to bundled visits: 98940 (spinal manipulation) generated $5.3M (3.8% of Medicaid revenue) and ranks #39 of 451 in-state (92th percentile), while 97810 (acupuncture, initial 15 minutes) generated $2.7M (1.9%) and ranks #94 of 645 (86th percentile). These patterns indicate the health center offers a range of primary care-adjacent modalities (physical medicine, acupuncture) that supplement core visit-based revenue.

A notable billing pattern is numerous procedure codes with substantial claim counts but $0 avg paid/claim (for example 97110, 90837, 97112, 99213, 99214, 99212), which is consistent with services being captured under bundled FQHC encounter payments rather than receiving separate fee-for-service reimbursement. For analysts, this suggests claims-level volume for specific therapies or E/M services may be underrepresented as direct revenue lines because payment is embedded in T1015/G0467 bundles.

From a competitive-standings perspective, the provider is a major FQHC presence on at least one state metric (G0467 extreme outlier) and a high-percentile performer on several other codes (00003 at the 93th percentile, 98940 at the 92th percentile). Overall, the combination of $140.6M Medicaid revenue, dominant bundled-visit income, and long tenure (NPI 2005-05-27) positions the organization as an established, Medicaid-centric community health operator with exceptional activity in at least one FQHC visit measure.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

82 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	120,400	$590	$71.2M
00003	N/A	78,430	$590	$46M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	32,890	$420	$13.7M
98940	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in one to two spinal regions.	11,980	$440	$5.3M
97810	The provider uses solid, metallic, fine, single–use needles to pierce the skin and stimulate anatomical points on or in the skin by manipulating the needles by hand during an initial 15 minute…	4,390	$620	$2.7M
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	3,180	$380	$1.2M
G0466	Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more…	490	$490	$239.6K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	1,130	$70	$74.6K
97811	The provider pierces the skin using one or more needles and stimulates anatomical points on or in the skin by manipulating the needles by hand. This code represents each additional 15 minutes of…	1,020	$50	$47.9K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	200	$130	$26.9K

Showing 1–10 of 82

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Lake County Tribal Health Consortium Inc. — 1 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

82 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	303	1,550	38,050	$190	$14.1M
00003	N/A	51	690	14,940	$260	$7.7M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	266	4,290	780	$140	$400.1K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	7	1,030	1,050	$70	$219.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	421	2,110	1,330	$30	$200.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	129	1,950	500	$80	$179K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,175	13,300	640	$40	$169.6K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	9	160	190	$180	$141.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,011	4,230	210	$110	$135K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	277	1,170	1,000	$20	$126.4K

Showing 1–10 of 82

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sutter Bay Hospitals	CA	Critical Access Hospital	$0	$39.5M
Mendocino Community Health Clinic, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$23.7M
Gregory Hadfield	CA	Medical Physician Assistant	$439.9K	$0
Kinston Cummings	CA	Physician Assistant	$206.9K	$0
Keith Donald	CA	Surgery Physician	$104.9K	$76.3K
Matthew Mcquaid	CA	Foot & Ankle Surgery Podiatrist	$167.4K	$0
Fareed Asfour	CA	Infectious Disease Physician	$31.1K	$0

Lake County Tribal Health Consortium Inc. — Billing Profile & Reimbursement Data

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Lake County Tribal Health Consortium Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References